The Mita clinic in Kodaira city, Tokyo, has carried out blood examination and thyroid ultrasound examination on 1,500 patients, including children. Mamarevo Magazine here interviews Dr. Mita, the head of the clinic, about what he has seen through the blood exam.

Q: Please tell us about the examinations that are conducted by the Mita clinic.

A: Since October 2011, we have carried out blood examinations, which include ‘differential white blood cell count’, and thyroid ultrasound examinations. The WBC (white blood cells) consist of 5 different kinds of cells: neutrophil, lymphocyte, eosinocyte, basophil, and monocyte.

The ‘differential WBC count’ consists of comparing the ratio of occurrence between these five cell types. Workers who work in environments with high radiation levels have to take ‘ionized radiation health checks’, which particularly focus on ‘differential WBC count’.

In the current situation, thyroid ultrasound examinations have been getting a lot of attention, but I consider differential WBC count to be rather important as well, for assessing the effects of radiation.

Q: Do you mean that we can understand the impact of radiation on humans by checking differential WBC count?

Mita: Yes. Blood is produced in the bone marrow which is one of the organs that are most vulnerable to radiation. If the bone marrow is exposed to high doses of radiation, the quality and ratio of blood corpuscle cells can be changed. The values of differential WBC count can be affected easily by even tiny inflammation in the body.

So, in our clinic, we first take a close look at patient’s condition such as the symptom of inflammation and liver function. If a patient is diagnosed with such conditions, we ask him/her to undergo the blood examination only after full recovery.

It is possible to see tendencies of areas by evaluating the data of hundreds and thousands of people.

So, if the mean value of the result of the collective blood exams is not very good, it can indicate the need for decision-making of whether one should keep living in the area.

By the way, in the ongoing Fukushima Health Management Survey in Fukushima prefecture, the differential WBC counts have been conducted only on residents who have resided in the evacuation zone. But I think that all the residents in Northern Kanto and Metropolitan Tokyo areas should be encouraged to take this examination.

Q: You have found changes in the children’s differential WBC counts. Could you tell us about it?

Mita: Yes. Our patients mostly come from Tokyo, Chiba, Kanagawa, Saitama, and other Northern Kanto areas. I have found an obvious decline of neutrophil value in leukocyte (WBC) of these children.

The pediatricians’ general textbook says that reference value of neutrophil for healthy children (6-12 years old) is between 3000 and 5000. 3000 is considered as the threshold value. But the mean number of neutrophil values of the children who have visited our clinics since the accident has decreased to 2500. The mean value should normally be 4000, but it has shifted to 2500. It is lower than the threshold value of 3000. I think this points at a serious problem.

Mita: Decrease of neutrophil does not directly cause lowered immunity strength. Neutrophil usually takes up 60% of all leukocytes and it kills bacteria and fungus which enter the body by incorporating them inside its own cell. Neutrophil functions as the last bastion of the immune system, which means that there are a number of stages in the system before neutrophil is called upon to suppress the actions of bacteria and fungus.

So, a decline of neutrophil value does not mean it immediately causes weakness in catching cold and infectious diseases. But we should be careful that extremely low values of neutrophil can lead to fatal illnesses such as septicemia in the case of aggravated colds.

Q: Can you give some concrete examples of the kind of symptoms we will see when the value of neutrophil decreases?

Mita: Even if the level of neutrophil is low, that doesn't necessarily mean that children will feel bad or that they will be vulnerable to disease. Like I said before, it means that once a child becomes sick and the condition doesn't improve, the risk of that child’s condition becoming serious increases. Furthermore, not only will the value of neutrophil become abnormal but you will also see some changes in the physical condition.

In the summer of 2011, there were many children with bloodshot eyes; and what we saw most were children with dark circles under the eyes. We also had increased occurrence of sinusitis. Previously, these patients got better soon after they were given proper treatment; however, we are seeing more cases of sinusitis accompanied with mild case of asthma continuing for longer periods. And when these children spend some time in the West, they get better. If at all possible, I would like them to move away from East Japan.

Q: Is the decrease in the value of neutrophil caused by the radioactive contamination?

Mita: Since radioactive substances coming from Fukushima Daiichi nuclear power plant have reached Tokyo, and huge amounts of contaminated waste is being burned here as well, I cannot deny the possibility that we are inhaling radioactive substances contained in the air.

Again, let me repeat that after the nuclear accident, enormous amounts of nuclear substances were released in the environment. Therefore, if we see an increase in symptoms that are different from the ones we've seen before, we physicians should "first consider the effects of radioactivity."

Q: What should be done if the value of neutrophil is low?

Mita: As far as the numerical values of tests taken by children at our clinic are considered, even if the neutrophil value is low, we have seen that in most cases these children will recover after spending more than two weeks in Western Japan.

When we tested a child whose original neutrophil value was 1,000, after the child had spent some time in Nagano, the level had recovered to 4,000. We've also had a child whose value was 0 (zero), but the level rose to 2,000 after spending about 2 months in Kyushu and then eventually to 4,000.

But if the value is really low, some children have difficulty recovering to the average level of 4,000 even after evacuating to the West. So my advice is: if you see some abnormal changes in the numerical neutrophil value, you should evacuate to a place that is not contaminated.

The value of neutrophil has been relatively stable among children who have evacuated to a clean place even for a few weeks at a time. But my real hope is to have not just children but also adults move away from Tokyo.

Q: Have you seen some abnormal values of neutrophil among adults as well?

Mita: I have not seen any real change among adults, but their conditions are definitely different compared to how it was before the nuclear accident.

With elderly people, it takes more time for asthma to heal. The medication doesn't seem to work. We also see more patients with diseases that had been rare before; for example, polymyalgia rheumatica is a disease common among those above age 50 and contracted by 1.7 people out of every 100,000. Before 3.11, we had one or less patient per year. Now, we treat more than 10 patients at the same time.

Q: How do you evaluate the overall results of the thyroid ultrasound scan tests?

Mita: We didn't observe any serious results among the children we tested. However, we have found two mothers in their 30s with thyroid cancer. Women are more likely to contract some kind of thyroid disease, and it is possible that the radioactivity may have caused the nodules to develop into cancer.

It is also possible that we may always have had a certain number of young people with thyroid microcarcinoma that eventually developed into real cancer as the young patients became older. And it just so happens that now, by conducting close examination, we have come across these cases of thyroid cancer.

Ten years after the Chernobyl accident, the number of adult thyroid cancer patients rose as well. So, I think we need to give regular checkups not just on children but on adults as we I want doctors to rise as well.

Q: Isn't it true that after the Chernobyl accident, local doctors were aware of the effects seen among their patients.

Mita: Yes. I think doctors who knew their patients well should become aware of the strange things that were happening to them. But since we don't know exactly how much these patients were exposed to radiation, it is really difficult to present a cause and effect relationship.

What we need to do is to have one group of people who have been exposed to radiation and another group who have not been exposed; then conduct the same tests. But we don't even know how much the people in Tokyo were exposed in the first place. It would also mean having to bring in hundreds of healthy children and take blood samples.

That's something, which is simply beyond the reach of one single physician. In other words, it's impossible under the present state to collect the kind of data that would be printed in a prestigious science magazine. Still, as long as I know that something strange is clearly happening, I can't just sit here doing nothing.

After 3/11, I've asked a group of doctors many times to "conducblood tests on children," but all they said was "there are no effects caused by radiation," without any explanation. These types of tests need to be conducted for the next 20 or 30 years in order to understand the effects.

We've already wasted the first two-and-a-half years, but since we have the data from Belarus and Ukraine, doctors should study and learn properly about the effects of radiation on the human body, listen to the sayings of patients and conduct investigations.

Mita: Try to be honest and tell your doctor that you are concerned about the effects of radiation; therefore, you would like to have your blood tested. Some doctors may give you an unhappy look, but this is the only way we can change their way of thinking. I recommend people to get their blood tested along with the thyroid ultrasound scan test once every year.

Anti-nuclear demonstrations in front of the prime minister’s official residence on Fridays have been growing rapidly in size week by week.

The organizers, Metropolitan Coalition Against Nukes, is a coalition of multiple anti-nuclear groups and individuals, particularly inspired to try and prevent the restart of the nuclear power plants all of which had been offline since May 5, 2012.

Lately, there has been a move from some of the organizers to “remove” a prominent activist, Kouta Kinoshita, or rather, remove his claim of health effects from radiation exposure from the anti-nuclear movement. An investigative journalist who did an onsite coverage of the 1999 Tokaimura nuclear accident, Kinoshita was keenly aware of dangers of radiation when the Fukushima accident happened.

He has spearheaded an effort to bring truth to the public about radiation and radiation exposure, calling for evacuation of children, pregnant women, and women of childbearing potential from Tokyo and Kanto regions. (Evacuation from Fukushima and other severely contaminated areas goes without saying.)

Apparently some of the organizers do not like Kinoshita’s claim. Kinoshita encouraged readers of his popular blog (http://blog.goo.ne.jp/nagaikenji20070927) to attend the protest on June 22 and June 29. He no longer recommends the protest to his readers, as he does not agree with their stance of not acknowledging health effects and of lack of opposition to the debris distribution and incineration. In addition, he is not recommending that his readers attend the protest because the organizers do not seem to have contingency plans. Even when he was recommending protest attendance, he discouraged people from taking children there.

As Kinoshita has claimed over and over, the Tokyo area has a significant degree of radiation contamination. Some places are as contaminated as Kiev was after Chernobyl. However, some do not want to admit Tokyo is contaminated. It is very inconvenient for them. Kinoshita has been verbally attacked numerous times for “spreading the baseless rumors” and “scaring people.”

However, health effects are real. People contact Kinoshita to report their health problems since the Fukushima nuclear accident, as doctors do not seem to acknowledge them. Children who evacuated from Tokyo and Kanto region are being diagnosed with thyroid cysts and/or nodules.

One of the main members of the coalition with the Twitter account name, @bcxxx, declared that anything relating to Kinoshita be “removed” from the anti-nuclear movement. Kinoshita had already received slanderous comments from this individual in the past. He contacted the coalition for an explanation.

One individual, who seemed to be the central figure in organizing the demonstration itself, replied saying she was too busy at the moment and wanted some time to answer the question. Someone from one of the coalition’s groups revealed to Kinoshita that the coalition was simply a get-together of groups and individuals without regular face-to-face meetings.

Soon after the initial exchange, Kinoshita received a polite e-mail from one of the coalition’s members, Yasumichi Noma http://twitter.com/kdxn, thanking him for his effort to attract people to the demonstration. Noma stated that @bcxxx’s opinion did not necessarily reflect the coalition’s position and asked for Kinoshita’s understanding. Noma also stated the coalition had no particular representative.

Within 24 hours of receiving Noma’s e-mail, Kinoshita saw surprising Twitter exchanges between Noma and @bcxxx. Kinoshita had already called for non-attendance of the Friday demonstration, after @bcxxx’s “Kinoshita removal” declaration. Noma tweeted that it was rather preferable that Kinoshita called for non-attendance. Noma also tweeted that he thought the fact they were “hated” by Kouta Kinoshita would be a positive influence on their movement.

What is being uncovered from this whole sequence of events is that some of the organizers of the demonstration do not seem to have any views beyond just being “against nuclear power plants.” They don’t seem to acknowledge the existence of health effects from radiation exposure.

They don’t seem to recognize the ramification of regional distribution and incineration of contaminated disaster debris. They just care about stopping nuclear power plants. As a matter of fact, some protesters have been asked by them not to bring up such topics as health effects or debris incineration at the demonstration.

The organizers do not have cohesive unity among themselves. They do not seem to have any contingency plans in case the demonstration becomes violent. They are telling everyone to just “come on over” to the prime minister’s residence to protest. As a result, there are families with children, mothers with strollers, and literally people of all ages and background in attendance.

A wonderfully democratic sight? Think again.

Without a clear consensus amongst the organizers about what their collective stance is, where is this demonstration going? Just a bunch of people gathering? Has everyone thought beyond “Saikado hantai!” or “We oppose restart!”? What if the Prime Minister Noda answers the call and comes out to greet the protesters? Does the coalition have a letter of statement prepared to present?

It might be a matter of time before the demonstration become violent and out of control. Is it really a good idea to bring babies and children there? It is not a parade after all. Not to forget potential for radiation exposures.

There is even talk of the demonstration being setup by the pro-nuclear side to let citizens “vent” their anger to pacify them.

Whatever the truth is, this might be a time to profoundly consider where we want to go and how we want to present our concerns.

• Kouta Kinoshita, after graduating from Chuo University Law School, began investigative reporting. In 1995, he covered a series of cases including the Subway Sarin Incident by Aum Shinrikyo, a Japanese cult group. Also, he did an on-site coverage of Tokaimura nuclear accident from the very beginning, which was the first nuclear accident in Japan that resulted in deaths from radiation exposure. This experience led to his awareness of dangers of radiation.

Furthermore, he organized soil testing for radiation contamination for the entire country of Japan and developed the Radiation Defense Project in order to prevent the spread of health damage due to radiation. There are volunteer groups in Okinawa, Kyushu, Chugoku, Kinki, Shikoku, Chubu, Tokyo, Hokkaido and Europe at this time, allowing the interaction between a total of 3000 members. His blog, a very important information source, is accessed by an average of 20,000 viewers on a daily basis.